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Mannorin System Certification JUL <br />F. In -Tank Ganging / SIR Equipment: [9 Check this box if tank gaugingpAtp %" drEALTH <br />0 Check this box if no tank gang Lm <br />This section must be completed if in -tank gauging equipment is used to perform leak detection monitoring. <br />Complete the following checklist: <br />C3 Yes <br />0 Nam <br />Has all input wiring been inspected for proper entry and temination, including testing for ground faults? <br />0 Yes <br />0 No* <br />Were all tank gauging probes visually inspected for damage and residue buildup? <br />[j Yes <br />0 NO <br />Was accuracy of system product level readings tested? <br />0 Yes <br />0 No* <br />I Was accwacy of syncir, water level readings tested? <br />[I Yes <br />[I NO <br />Were all probes reinstalled property? <br />❑ Yes <br />0 NO <br />Were &I I items on tite equipmettt mall dcturers maintenance checklist completed? <br />* In the Section K, below, describe how and when these deficiencies were or will be ewrected. <br />G. Line Leak Detectors (LLD): 0 (beck this box if LLDs are not installed. <br />Vemnlete the ralinwina rhprkliat! <br />9 Yes <br />01 No* <br />For equipment start-up or annual equipment cartification, was a leak simulated to verify LTjD pafonnance?, <br />[I N/A <br />(Check all that apply) Simulated leak rate: 0 3 g.p.h.; [10. 1 g.p. h; 0 0.2 g.p.h. <br />0 Yep <br />0 'No* <br />Were all LI Ds confirmed operational mid accurate within regulatory requirements? <br />19 Yes <br />rl NO <br />Was the testing apparatus properly calibrated? <br />9 Yes <br />Cl No* <br />For raecharalcal LLDs, does the ULD restrict product flow if R detects a IeWl <br />0 N/A <br />0 Yeq <br />0 NO <br />1'or electronic Ul)s, does the turbine automatically shut off if the LLD detects a leak? <br />0 N/A <br />0 Yes <br />0 No* <br />For electronic LLDs, does the turbine automatically shut off if any portion of the nwitoring system is disabled <br />Ig N/A <br />or disconnected? <br />r7l Yes <br />0 No* <br />For cleLtroniv LLDs, does tk- turbine antornatical'y shut off if any portion of the monkoring system malruActions <br />g N/A <br />or fails a test? <br />[I Yes <br />E3 No* <br />For clactronic, LLID%, have all accessible wiring connections been visually inspected? <br />0 NIA <br />9 Yes <br />0 No* <br />I Were all items on the equipmem manufacturer's maintenance cbeckl ist completed? <br />In The Section H, below, describe how and when these defthmeles were or will be corrected. <br />IL Comments: <br />Page 3 of 4 <br />17-d C9699V960Z <br />wnelOJ19d elqeijei j e0C:90 t, [ 8 l, Inr <br />